The Pap smear used for cervical cancer screening was invented by a man, who knew? Cervical cancer is a deadly cancer around the world and over 90% of cases are caused by infection with certain types of the human papillomavirus (HPV). Thankfully we have an effective and safe vaccine against HPV available which can help curb infection rates. Even though we have this vaccine, HPV is still being transmitted and cervical cancer is unfortunately still developing, as described in Leila’s Isala blog. For over 100 years, the Pap smear has been used to detect abnormal cervical cells but there’s a new method for detection available. Continue reading to learn more! 🙂
How do we detect cervical cancer?
Cervical cancer is the fourth most common cancer in those with a cervix and early detection is key to treatment. Most people with a cervix have at least heard about the Pap smear, a method for screening for cervical cancer. The Pap smear has been in use for nearly 100 years credited to George Papanicolaou, a Greek physician. He was assisted by his wife, Andromache, who was a skilled laboratory technician and provided many, many samples for testing. The Pap smear involves scraping cells from the cervix and looking at them under the microscope to search for any abnormal human cells which may indicate cervical cancer. Samples are collected in a medical office by a physician or nurse, starting sometime after a person turns 25 and happens every 3 years in Belgium, if results are normal. These guidelines vary depending on the country and can change as more and more research is done to update the efficacy of this test. To be able to take such sample, the vaginal walls are first separated using a speculum (see picture) whereafter cells from the cervix (the bit that connects your uterus to your vagina) are collected. This method is quite labour intensive, requires skilled technicians to examine samples, is prone to false positives (and false negatives) and above all is quite invasive!
A self-test as an alternative screening method?
As an alternative to the Pap smear, some scientists decided to flip around what we should be looking for when screening for cervical cancer. According to them, instead of looking for abnormal cells, we should be looking for the presence of HPV and if detected follow-up testing can happen. This type of testing is highly effective and just as accurate as Pap smears, if not more effective. The exciting news about this type of testing is that it can be done by the person being screened, also known as self-sampling. Those of you familiar with Isala already know that we are BIG fans of self-sampling! It means sample collection can be done in the privacy of your own home and under your own conditions. Self-sampling is more convenient, less invasive and provides better trauma-informed healthcare. In case this is a new term to you, trauma-informed care is an approach towards healthcare that seeks to treat each patient with approachable and inclusive practices including taking into consideration past trauma that may impact receiving healthcare such as sexual, physical or emotional abuse. Undergoing an exam by a physician such as a Pap smear can be potentially traumatizing or retraumatizing for individuals. Allowing people to take control of their own testing is a great way to provide this trauma-informed healthcare. Cervical self-sampling is currently being adopted in different countries around the world, including Canada, my home country! The province where I am from announced that Pap smears will no longer be the standard and instead cervical self-sampling will be implemented for people aged 25-69. Even though I won’t be able to experience this new type of testing myself I’m so excited for my fellow Canadians that are!
Now that I got you so excited for cervical self-testing, I have some bad news too… Unfortunately, Belgium has not adopted this system as of early 2024. Cervical testing is done for people of 30 years and older, but this is done through samples collected by a clinician. Those younger than 30 still have Pap smears performed, also by a clinician. Luckily, there are clinician scientists in Belgium that are investigating the self-sampling option and its efficacy. One of them is Professor Veronique Verhoeven who you might remember since she is the responsible clinician of our Isala project. She published an article in 2022 showing that HPV self-sampled swabs collected by people in Ecuador were just as accurate as those collected by a clinician. With more and more countries adopting this type of testing it is my hope that Belgium will adopt similar policies that empower the people that live there and help them to take control of their healthcare!
Who am I?
Hello everyone! My name is Brianne. I just moved to Belgium at the beginning of 2024 to start my newest adventure – a PhD. I was born and raised on the west coast of Canada and am very excited to learn more about Belgium. I will be working alongside and supporting the Isala team although my actual PhD research in the lab of Professor Sarah Lebeer will focus on strawberry plants. I am very interested in science communication and women’s reproductive and sexual health. Match made in heaven with Isala, right!? In Canada I volunteered at a low-barrier, judgement-free sexual and reproductive healthcare clinic that does a lot of great work for the community. I really enjoyed my time there and learned a lot! When figuring out my next step in life I came across a scientific article written by Professor Sarah Lebeer and others, all about Lactobacillus iners, a unique vaginal resident, and I was hooked! I wanted to join this research group and learn more about the bacteria around (and in) us.